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EnvSrorsmentafl Health Department <br />10. <br />12. <br /> Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> One separate tub (bucket or basin) for the collection of rinse/wastewater. <br /> Paper towels and pump-style soap container. <br />13. <br />**lmportant** <br />Completed by: 14. <br />Signature <br />Paper Hand Towels <br />7. <br />..BlaacliPrepare Stow <br />Propane Tan!; <br />Bleach and Water <br />Rre Extinguisher <br />ice Cooler <br />.I am providing the following for adequate hand washing facilities, but' separate from utensil wash within my <br />booth: <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />Sterna vaCbafling <br />Dish <br />5 Gal Hand vzash <br />Waslewator Container <br />5^0 .Gal. <br />Hand wash Water <br />Sanitizer huefcet- <br />bleach & water for <br />storing wiping clothsJ <br />SANJOAOUIN <br />------COUMTY------ <br />C-'rcctt;r;.rs h<?rc. <br />£ <br />I Extra A <br />Waler <br />C>Cc^ e-.'" <br />Title <br />Extra Ice Bags 4 Food Containers must he <br />stored 6 inches ott of the groundl <br />Date <br />7 <br />Soap and Waler <br />Health Permit <br />JF <br />Rinse Water <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. A copy of this checklist must be in the booth at all hours of <br />preparation and ppar^tioryo Return original to festival coordinator three weeks prior to <br />this event. X-/ <br />Garbage <br />Can' <br />Names of responsible persons to be present in booth during all hours of operation: <br />J 1S ‘^~2^________________________________________ <br />Soap dispenser <br />1868 E. Hazelton Avenue | Stockton. California 95205 | T 209 468-3420 | F 209 464-0138 [ www.sjcehd.com <br />EHD 16-02 ’ Page 8 of 11 TEMP EVENT APP <br />07/3/17 <br />T- 1 . ) <br />- ' .r . <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41°F temperature): <br /> Ice chests ^Refrigerator <br />^-'Refrigerated truck Ice bath and tubs ,r~~ <br />s.-. .:^^ r:-.^A^,..Qnther(speciM_____________________________7 I / '_______________________________ <br />^>sF7'-'7^^^iding the following items within my booth for the sanitary cleaning of food preparation utensil <br />Sd*':’* _v''—compartment sink. <br />OR ' <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution.